Policies for paid childbearing or family leave for residents are lacking at top-ranking medical schools and may be exacerbated by lack of direction from specialty boards, according to two research letters published in the Dec. 11 issue of the Journal of the American Medical Association.

Kirti Magudia, M.D., Ph.D., from Brigham and Women's Hospital in Boston, and colleagues reviewed institution-level childbearing and family leave policies for 15 graduate medical education (GME)-sponsoring institutions affiliated with 12 top-ranking medical schools. The researchers found that seven of 15 institutions had an institutional GME policy allowing for paid designated childbearing leave. The mean duration of paid childbearing leave was 5.7 weeks, while the mean duration for maternity leave, which included both childbirth leave and designated family leave available to childbearing mothers, was 6.6 weeks. In addition, seven institutions had policies on paid family leave for nonbirth parents, with six institutions using inclusive language for same-sex couples and adoptive parents. At these seven institutions, the mean paid leave for a parent not designated as primary was 3.9 weeks.

In a separate study, Briony K. Varda, M.D., from Boston Children's Hospital, and McKinley Glover IV, M.D., from Massachusetts General Hospital, compared leave policies for resident physicians among 24 American Board of Medical Specialty (ABMS) member organizations. Nearly all boards (22 of 24) had leave policies, but only 11 specifically mentioned parental leave as a potential reason for residents taking leave. However, no boards had a separate policy for parental leave. For board eligibility, 20 boards had time-based training requirements and allowed leave for any reason for a median of six weeks during any one year. Eight boards mentioned allowing program directors to seek exemption of resident physicians from time-based training requirements without extending training duration.

"Balancing the needs of resident physicians, training programs, and specialty boards may require novel approaches such as use of competency-based rather than time-based training milestones to determine eligibility for board certification," Varda and Glover write.

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